1) 🇫🇷 Study from Angers University Hospital found that only a quarter (26.4%) of 220 Long Covid patients had post-exertion malaise (PEM). PEM was linked to earlier COVID onset in 2020/2021 and higher fatigue.
2) Looks like the authors used a strict definition of PEM (from the ICC and CCC criteria for ME/CFS). They describe it as a "pathological post-exertional response, not a simple increase in fatigue level" and require it to last 24 hours. 3) The results of theirs statistical model for predicting PEM is shown in the graph below. Lack of vaccination, POTS, palpitations and orthostatic hypotension were associated with PEM but did not reach significance. Gender and age were seemingly unrelated to PEM.
4) One of the main findings from this study is that PEM was approximately six times more frequent among Long Covid patients infected in the preOmicron period relative to those infected in the Omicron period. 5) Although almost all patients had fatigue, only a quarter had PEM. 7.3% of 220 Long Covid patients had POTS, while 10.3% had orthostatic hypotension. The prevalence of mast cell activation disorder (MCAS) was much higher at 62% (possibly because it relied on questionnaires). 6) Link to the open-access paper: Ghali et al. 2026. Post-Exertional Malaise in Post-COVID-19 Syndrome: A Shift in the Frequency Across Pandemic Phases.
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